Early-life determinants of cardiometabolic outcomes and accelerated biological ageing in Colombia

Background: Adverse childhood experiences (ACEs) are critical early-life determinants of long-term health, yet their association with biological ageing and cardiometabolic risk remains poorly understood.We examined the association between ACEs, cardiometabolic outcomes and age acceleration among older adults in Colombia.Methods: Data were drawn from 3,385 adults aged ≥60 years (1,726 women, 1,659 men) from the nationally representative Health, Well-Being, and Ageing Study (SABE-Colombia).Five ACEs before 15 years old were assessed: emotional abuse, domestic violence, poor self-reported health, scarcity of food, and forced childhood migration due to armed conflict.Biological ageing was estimated using Klemera-Doubal Method for Biological Age (∆KDMAge).Associations between ACEs and cardiometabolic outcomes (cardiovascular disease CVD, diabetes, hypertension, and obesity) were evaluated using logistic and Poisson regression models; and associations with biological ageing using linear regression models, adjusting for sociodemographic factors.Results: Among women, emotional abuse (OR=1.68),domestic violence (OR=1.55),scarcity of food (OR=1.44),and poor health status (OR=1.66)were associated with increased odds of CVD (OR=1.68).Among men, forced childhood migration was associated with higher risks of diabetes (OR=1.60),CVD (OR=1.55),and hypertension (OR=1.43).Forced childhood migration was also associated with age acceleration (∆KDMAge β =1.52), with a stronger association in women (∆KDMAge β =2.67).Dose-response associations were observed between cumulative ACEs and CVD in women and hypertension in men.Conclusions: Early-life adversity, particularly forced childhood migration, is associated with higher cardiometabolic risk and accelerated biological ageing in later life, emphasizing the long-term biological costs of social and political instability.